Healthy Smiles in Rural Nevada

Lancette VanGuilder, RDH, BS, grew up in small towns across the United States — many of them in very rural parts of Nevada. “Although there are wonderful things about living in remote areas of our beautiful country, access to health care is not one of them. It was always evident to me that there were significant barriers to getting adequate health care when you lived far away from communities with regional hospitals and specialists. Dentistry was no different, but that just made my pursuit of a career in dental hygiene more appealing. I always wanted to help people and thought that a healthy smile was the greatest gift you could give someone,” she said.

After working in private practice for 22 years, VanGuilder launched Future Smiles of Northern Nevada as a nonprofit school-based oral health program funded by grants and private donations to help increase access to oral health care for children in rural communities. “I knew there were very limited oral health resources for families in rural Nevada, and with my public health endorsement, I could bring critical preventive services to children who need it the most,” she said.

Tooth decay is a preventable condition that may affect the overall health and well-being of children. Future Smiles of Northern Nevada provides dental disease prevention services in two counties, including one rural county classified as a 100% dental health care professional shortage area. Nevada ranks among the last in the nation with respect to oral health. The schools identified in this project have 56-88 percent of students receiving free and reduced-cost lunch. In addition, dental hygienists in Nevada may practice independently in public health settings utilizing a Public Health Endorsement. VanGuilder developed many collaborative relationships in the community to ensure that the children she sees have every opportunity to have a dental home. In addition, she also drew support from various organizations, including county alliances, a community-based health and wellness hub, the dental hygiene program at the nearby college, local federally qualified health centers, and two county school districts.

VanGuilder and her Future Smiles team utilized mobile equipment to provide students with oral health education and supplies, fluoride varnish treatments and dental sealants. Students with unmet dental needs were referred to established dental partners in the communities. They also utilized Sealant Efficacy Assessment for Locals and States (SEALS) to provide a snapshot view of oral disease rates and program success, in addition to electronic health records and data collection software. Pre- and post-tests were given prior to oral health education presentations to measure teaching objectives, and surveys were provided to the schools and parents to track satisfaction.

Thanks to the 2017 American Dental Hygienists’ Association’s Institute for Oral Health Wrigley Foundation Community Service Grants, VanGuilder purchased mobile equipment and supplies and hired two part-time staff members to help. Today, Future Smiles of Northern Nevada serves all grade levels at 10 high-risk schools within an 85-mile radius, providing oral health education, disease prevention, preventive services and follow-up case management to families.

“In just our first year of operation, we provided oral health education and supplies to 4,106 students, ranging from ages 4 to 18. I placed 635 dental sealants and provided 249 fluoride varnish treatments – in fact, we provided $35,549.67 in services! In addition, a few local dentists in the community offered to see children referred from our program and donated $10,000 in follow-up restorative services. Community-based oral health programs like Future Smiles of Northern Nevada can provide high-quality and cost-effective care to underserved populations!” VanGuilder remains passionate about access to care issues across our nation, the power of prevention and utilization of the dental hygienist.